exercise physiology

Stretching for cancer survivors is helpful to maintain muscle health – particularly after surgery [A how-to guide]

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Stretching is essential for many reasons in maintaining health & wellness. It can be done by anyone, at any time – and is very easy to do, and it is alright if you are unsure as I will show you how in this post. In general, the main benefits attained from stretching include:

  • Increased flexibility or Range of Motion (ROM)
  • Reduced likelihood of injury
  • Improved benefits when completing aerobic & resistance exercise

Before I go on, I would just like to let you know, I have created a new Facebook page called Exercise Cancer Community: Health & Wellness, to create a supportive environment for people to share their experiences. Please visit the page, click the Like button on the side of this page or on the FB site and pass it on.


Now, stretching is important for basically anybody to maintain or improve their physical health, but it is particularly important for cancer survivors who have undergone treatment such as a surgery. For example, women with breast cancer who have undergone a mastectomy tend to experienced reduced should flexibility, strength & mobility due to muscle and tendon tissue damage. In fact, here is a great article by Dr Robert Kilgour displaying that home-based stretching can assist in reversing these results, as published in the Journal of Breast Cancer Research Treatments. By engaging in stretching exercises (and eventually resistance training exercises), you will be able to achieve a level of health pre-surgery, or even greater. But if not, simple daily tasks around the house such as reaching into cupboards above the head, discomfort whilst driving or picking up a baby may become challenging.

Here is an example of a "spider-crawl" or "wall walk", where you slowly raise your arm up the wall to the level of your range (not to pain)

Here is an example of a “spider-crawl” or “wall walk”, where you slowly raise your arm up the wall to the level of your range (not to pain)

Before I show you individual stretches, here are the guidelines for stretching:

  • Stretches can be done daily or most days of the week (can do them up to 3-5 times/day)
  • Hold each stretch for 15-30 seconds
  • Repeat each stretch 1-3 times on each side
  • Have a deep breath in when commencing the stretch
  • Only complete the stretch to the full range of your joint (and not to a painful point)
  • Stretching is most effective when the muscles are warm, so after a walk is perfect

Here we go: If you are only a few weeks post surgery (1-3 weeks), you may consider doing “range of motion” exercises, that is just moving your joints to their point, and not pushing further.

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Above: Shoulder flexion & extension

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Above: Shoulder abduction

If these are simple, then lets move on to more stretches for the upper body:

Chest stretch:

  • Arm at 90 degrees against a wall, with forearm on the wall
  • Rotate body away from wall & hold

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Shoulder stretch:

  • Arm across the body
  • Other hand presses the elbow closer to the body & hold

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 Triceps stretch (only if your flexibility allows you to do so):

  • Arm above and behind your head, with elbow in the air
  • Hand above your opposite shoulder
  • Using your other hand, pull the elbow across your body & hold

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 Biceps & forearm stretch:

  • Arm directly in front, with fingers facing downwards
  • Using opposite hand, pull the fingers back & hold

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Do you see how simple some of these are? Definitely can be done at the office, in an elevator or at home! I constantly will be doing stretches to help aid my training sessions in the gym and at soccer around the office. Now here are some lower body stretches to do for the lower body:

Calf stretch:

  • Place hands on the wall
  • Take a step backwards with one leg, with foot placed flat on the ground
  • Bend the front leg, straighten the back leg and feel the stretch

With both feet flat, act as if you are trying to push the wall down. You should feel this in the back of your behind leg

Hamstring stretch:

  • (seated or on a yoga mat) put one leg out as straight as you are able to
  • Lean towards your foot, with your hands together
  • Aim to keep your back straight
  • Point your toe backwards for a greater stretch
  • Resistance bands can also be used for a greater stretch
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If less mobile, use a chair for support

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If you are more mobile and have progressed your flexibility, try a greater stretch using a resistance band

 Quadriceps stretches:

  • Find a stable object for support (wall, table, exercise bike!)
  • Grab your foot of the leg you are stretching
  • Keep legs in-line with each other and pull until you feel a stretch
  • You can also use a resistance band or rope around your foot to assist if you have limited flexibility

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Remember, every day you can partake in stretching, and before you know it, you will be improving your flexibility in no time. Combine this with your aerobic and resistance exercise and you are on your way to achieving a fantastic lifestyle.

Keep up the great work and please remember to provide encouragement to those in need, pass this resource on and keep continuing to send me questions and personal experiences.

 

Your Exercise Physiologist,

David

“Live in the peace of the moment; on your bike!” – an inspirational journey

Usually when you talk about cancer, or hear about somebody being diagnosed with cancer, we are instantly jumping to negative thoughts. However, we often miss the rest of the cup, the cup that can be half full if we wish it to be – the cup can even be three quarters full if we wanted it to be! 

Today I will speak of my encounter with Helene O’Neill. Helene is definitely a glass is three-quarters full kind of woman. A few weeks ago I presented my research at the Australia and New Zealand Gynaecological Oncology Group (ANZGOG) annual scientific meeting in Canberra, Australia – a meeting for the latest in women’s cancer research. It was a great day with some amazing oncologists presenting their research, interesting debates but also an initiative to have volunteers who assist with patient support groups enlighten us of their experiences. This is powerful because at the end of the day, I, along with others have passion for the health industry to help each individual person.

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Now Helene, a Uterine cancer survivor, did not sound like anything could get her down, and would rather take life by the horns. She spoke with such confidence and pride. She had strength that needed to be witnessed, as she is an inspiration for cancer survivors around the country, and this is evident with her passion for exercise and the community work she does with ANZGOG. I needed to find out more from her and her story, to share it, and assist in inspiring and motivating others so I asked her a few more questions….

Helene was diagnosed in 2007 around the same time her hometown of Newcastle flooded, which included her house. Her mother-in-law also passed away around the same time so it was a particularly sensitive period to say the least. Her oncologist, Dr Geoff Otton removed a grapefruit-sized tumour from her, performed a hysterectomy and removed lymph nodes, but she did not require radiation therapy.

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(above – The 2007 Newcastle floods were not going to hold Helene back)

I asked Helene how she felt physically and emotionally right after her treatment. She said “I was extremely tired in the early part and did suffer a loss of confidence with things like exercise”, which is completely understandable, right? “My bike is my friend and I remember the first time I went for a ride after the operation – a trip that normally takes 10 mins took me 30 mins – I was paranoid !! My quality of life was affected as the fear of lymphedema scared me but I attended a clinic and learnt a lot about the condition so I could get on with life.”

So the tasks usually simple to Helene were suddenly much more of a challenge, and that is where it is important to take the necessary steps to regain your fitness, be inspired and get back your lease on life. Helene was always healthy and physically active and her cancer diagnosis was not going to stop her. At first she feared she may have to stop exercising, but put that behind her as being active made her feel healthy and happy.

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(above – Helene getting back on the bike)

The self-proclaimed “super-competitive” former gym instructor is keen to try any form of exercise. Happy to avoid gyms, Helene likes to run, row, ride bikes and swim. She also enjoys sports – tennis, badminton and coaching soccer! Now, I thought I was super-sporty, but she is giving me a run for my money!!

I asked what a typical week of exercise looked like for her just to put into perspective:

Weekdays:

* Most mornings – mixture of running, riding, rowing and swimming – 1 hour

* Cycle to work (and also on the job) – about 1 hour

Afternoon/evening walk – 45 mins

* Sport: Tennis on Mondays (1 hour), Soccer on Tuesdays (1.5 hrs) and Badminton on Fridays (2 hrs)

Weekends:

* Variety of surfing, bush walking and paddle skiing

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(above – for those who don’t know paddle skiing, it is a water sport requiring a great amount of core abdominal strength, and is also very fun!)

I’ve spent much time talking in previous posts of the benefits of exercise in scientific research, but what also matters is how each individual feels. So how does being active make Helene feel? “I love the adrenalin rush. I also know that exercise is one aspect of my life that I am in control of. I like to exercise on my own so I can vary the activity, the pace and the duration and use the time to get to know myself better.” She is in the minority of people who requires little encouragement to exercise, so she definitely doesn’t need me running around telling her she is doing a great job, considering she has been a representative sports athlete since she was 5 years old. Even sometimes her husband tells her to slow down, as she “refuses to let age and health get in her way“. Amazing!

However, it is not without its challenges, the risk of lymphedema and infection remain a possibility, but she is willing to meet those challenges head on.

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Now as an ambassador for ANZGOG and to patients in rural areas, I asked Helene if she could provide a few words of inspiration to survivors who may be newly diagnosed or struggle for motivation. I often think these words are way more powerful from somebody who has had these experiences and bounced back, rather than a health professional like myself, who cannot speak of cancer first-hand – and this is what she said:

“Support comes in many forms but the one person I can rely on is myself. I encourage patients to steer away from the excuses, listen to their body and view exercise as one of the means to get well. There’s the adage ‘that cancer isn’t a sentence’. Basically it’s an opportunity to discover a ‘new’ you. Whilst everyone has a different cancer trip, it’s better to live in the present and enjoy every day to the max. I love to share my story – not the cancer journey – but the day-to-day highlights that I enjoy. Sure you reflect on the past but that’s not going to change – live in the peace of the moment. On your bike !!!”

I really hope you have found Helene’s story inspirational, as I have. Pass this story to somebody who you care about, a friend or a family member who can benefit from the support. Share on Facebook or Twitter to keep growing a community. Follow this blog for more posts, provide any comments or questions, join an e-mail list and like me on Twitter. Any questions, feel free to get in touch as well by e-mail.

Your Exercise Physiologist

David Mizrahi

E-mail: d.mizrahi@unsw.edu.au

Twitter: @Davemiz_EP

 

Encourage a friend, a family member, a loved one

Thanks for the overwhelming response in readership I have received over the past few weeks from all around the world, it is great that there is growing interest in taking charge and moving forward after diagnosis. I would like to use this post to try and get the word out, to share some lifestyle tips and provide encouragement to those who have been affected by cancer. My previous posts have highlighted that exercise is safe and provides numerous evidence-based benefits during various treatment types and after treatment. 

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Today, I would like all of my readers to share this blog with somebody they know – a friend, a family member, a work colleague, through Facebook, Twitter, email or word of mouth, who has had somebody in their lives (as so many of us have) affected by cancer. I want them to know that they are not alone in their journey, that there are many people, including myself, a complete stranger, who is willing to help improve their quality of life. 

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By connecting the community, we can share each others stories, experiences, challenges and triumphs – and that can be valuable to encourage people. I wish to gain peoples stories from diagnosis and thereafter, including how they began to exercise, what routines they got in, their likes/dislikes etc. so people who come along earlier into their journey can have some inspiration. 

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In the chemotherapy suits last year at Prince of Wales Hospital, Sydney, one of my patients who I had trained, was telling other ladies with ovarian cancer in the clinic how she had built up over the previous 6 months and was attempting her first City2Surf run (14km charity run). I was so impressed with her, she was so proud of herself. Although she stopped halfway for a coffee to enjoy the beautiful Sydney harbour views, it was a most amazing accomplishment. 

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Recruitment for my study went through the roof after that. Women were asking around the clinics to sign up, it was a great advertisement for living a healthy lifestyle, despite undergoing chemotherapy every week, and an example of a great supportive network.

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It is this power that I want to use by connecting people so we can share stories, read stories, have the inspiration to try go for a long walk, to have the inspiration to try and jog on the beach, to be inspired to go to a yoga class or a gym class, to ask my doctor what exercise services are on offer. 

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Please follow and share this with somebody who can benefit, who can re-gain strength and get more out of life, and feel free to get in touch with any questions, comments or stories you may have. 

As always,

Your Exercise Physiologist,

David

Twitter: @davemiz_EP

E-mail: d.mizrahi@unsw.edu.au